Individual provider Active NPI

Sharon Hirsch, M.D.

  • Psychiatry Physician
  • Oconomowoc, WI
National Provider Identifier
1730208406
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
64760 Issued in WI
Practice address
34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone
(262) 646-4411
Fax
(262) 646-1049
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 64760 WI
Psychiatry Physician 2084P0800X 64760 WI Primary

Addresses

Primary practice location

34700 Valley Rd
Oconomowoc, WI 53066-4500

Mailing address

34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411

Other identifiers 2

IdentifierTypeStateIssuer
036088827MedicaidIL
100048957MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022001935 WI Practitioner - Psychiatry 4981619483 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64760WIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Nov 6, 2016 Accepting new patients

Locations

34700 Valley Rd
Oconomowoc, WI 53066

1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527

1205 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 567-4828

11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1730208406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "SHARON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "64760",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "64760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088827",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048957",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.